What is Epstein-Barr Virus (EBV)?
Epstein Barr is one of the herpes virus family (HHV-4) and one of the most common viruses on earth. Most initial infections, known as glandular fever (or mononucleosis depending where you are in the world), are asymptomatic in the developed world. It is particularly prevalent among young adults and often diagnosed through specific blood tests. 30-50% of immune competent adolescents will display symptoms though. It’s the second most common cause of visits to the doctor by college students. After this initial phase it lives dormant in our bodies, and for some, it can reactivate.
Its impact on the body can be multifaceted, affecting not only the nervous system but also potentially contributing to conditions like leaky gut. In functional medicine, a field that focuses on holistic and integrated approaches to healthcare, the link between a weak immune system and the reactivation of such viruses is a significant area of focus. By understanding these connections, functional medicine aims to address the root causes of illness, considering the intricate interplay between different bodily systems.
About 90-95% of the population carries antibodies to it but most don’t have symptoms or reinfections. For those that do, however, it can mean serious health issues that can affect their whole life.
How do you get Epstein-Barr Virus?
Glandular fever, or the acute phase of EBV, also known as the ‘kissing disease” is mainly spread through saliva. It can also be spread through other bodily fluids like blood and semen, but this is less likely. Many people aren’t even aware they’ve had glandular fever or that they carry the virus but on testing they have antibodies and these people can also reactivate.
Identifying Primary EBV Infection: Understanding Blood Test Results
A primary infection of Epstein-Barr Virus (EBV) is typically indicated when specific antibodies are present in blood tests. The presence of anti-Viral Capsid Antigen IgM antibodies, without the antibody to EBNA (Epstein-Barr Nuclear Antigen), suggests an initial infection. Additionally, a primary EBV infection can be inferred from a high or increasing level of anti-VCA IgG and the absence of the EBNA antibody after about four weeks of illness symptoms. These test results help healthcare providers diagnose a primary EBV infection.
What is reactivated Epstein-Barr Virus?
In some people, EBV can reactivate. This can be like a milder version of the initial glandular fever but with more extreme fatigue, chronic achiness, sore throat, irritation of mucous membranes and swollen lymph nodes. It often appears with other health issues and viruses and the symptoms can come and go for years.
What causes reactivation of Epstein-Barr Virus?
Science doesn’t know all the answers yet. In my clients, I often see an episode of chronic stress around the time of the reactivation, plus another infection or issue like a parasite or bacterial overgrowth in the gut like SIBO. Some level of immune system dysfunction is often present.
Why does EBV reactivate in some people but not others?
Again, we don’t have the answers as to why Epstein Barr Virus reactivates in some people but not others. I do, however, see commonalities in the clinic that suggests there are triggers for Epstein Barr Virus reactivation. This is why a thorough health history and health timeline are necessary when putting the pieces of the chronic illness puzzle together. These things include:
- Mould illness (this is a huge topic that I aim to write about in the future)
- Gut infections and parasites
- Chronic stress or a very stressful life event. Consider physical, mental, emotional and spiritual stressors. Lack of sleep, over exercising, overmedicating etc.
- Methylation issues (again another big topic to discuss. Relevant for those with MTHFR SNPs)
- Toxins and heavy metals like mercury, EMFs, chemical exposure etc.
- Hormonal changes (puberty, menopause, postpartum)
- Lyme disease
- Poor nutrient status
- Poor blood sugar control. This is actually one of the most common and one of the most stressful things the body has to deal with. It is an invitation for more viral activity.
- Immunodeficiency & Immunosuppression
What are the symptoms of reactivated Epstein Barr Virus?
When EBV reactivates it manifests differently in each person but most commonly brings with it symptoms of chronic fatigue. The person often has other health complications as well because of immune dysfunction. The most common symptoms are:
Fatigue
Headaches
Myalgia (muscle pain)
Enlarged lymph nodes
Enlarged spleen
Weakness & body aches
Low-grade fever
Depression
Also, chronic illness which can’t be explained by other known disease processes at diagnosis (Okano, 2005)
What other diseases are related to EBV?
Epstein Barr Virus has been linked to many other diseases, including autoimmune disorders and certain types of cancer. The research supported conditions caused by or associated with chronic reactivated EBV are (references can be provided on request):
- Multiple Sclerosis
- Systemic Lupus
- Sjogren’s
- Rheumatoid Arthritis
- Chronic Fatigue Syndrome
- Hashimoto’s Thyroiditis
- Atherosclerosis/Acute Coronary Events
- Chronic Inflammatory Demyelinating Polyneuropathy (CIDP)
- Autoimmune Hepatitis
- Type 1 Diabetes
- Scleroderma
- Coeliac
- Inflammatory Bowel Disease. (Both Ulcerative Colitis and Crohn’s Disease)
- Glomerulonephritis
- Guillain-Barre Syndrome
- Guttate Psoriasis
- Immune Thrombocytopenic Purpura
- Juvenile Idiopathic Arthritis
- Polymyositis
- Psoriasis: Generalized Pustular Psoriasis
- Mixed Connective Tissue Disease
- Idiopathic Thrombocytopenic Purpura (ITP)
- Hodgkin Lymphoma
- Burkitt’s Lymphoma
- Nasopharyngeal Carcinoma
- Almost 10% of all Stomach Cancers
- Angioimmunoblastic T-cell Lymphoma
- Leiomyosarcoma
- Papillary Thyroid Carcinoma
- Malignant Lymphoma of the Thyroid
- Gastric Lymphoepitheliac Carcinoma
- B cell, NK/T cell Tumours, or Lymphoma
- Non-Hodgkin’s Lymphoma
- Cutaneous Lymphoma
- Posttransplant Lymphoproliferative Disorder
- Colorectal Cancer
- Breast Cancer
- Parkinson’s Disease (hypothesis)
- Encephalitis
- Meningitis
- Acute Disseminated Encephalomyelitis
- Cerebelitis
- Myelitis
- Cerebellar Ataxia
- Dyspepsia, duodenal ulcer, or GERD, especially with co-infections like H. pylori
How can we help Chronic Reactivated EBV sufferers?
Pharmaceuticals have limited efficacy for EBV and only work on one pathway. On top of that, the antiviral medications cause an excess of adverse effects and carry a high cost. While natural antiviral agents are safer and more broadly effective (A Vasquez, 2014) (Cohen, 2009).
The options we have for Nutritional antiviral therapy are:
- Direct Antiviral Support – Selenium, Liquorice, Lysine & Zinc
- Blocking EBV Replication (through NFkB inhibition of EBV) – Lipoic acid, NAC, vitamin D3, Curcumin, Proteolytic Enzymes, Propolis, Boswellia, CoQ10, Green Tea, Grape Seed Extract, Selenium, Resveratrol
- Methylation Support – Folinic Acid, B12, D3, B6
- General Antiviral Nutritionals – Vitamin D, vitamin A, Fatty Acids, Probiotics, Zinc, Vitamin C, Multimineral, Glutathione support, Glutamine, Lactoferrin, Whey Protein Isolate, Melatonin
- Cell-System Support (EBV damages cells, including the mitochondria)- L-Carnitine, Alpha lipoic acid, CoQ10, Omega-3, probiotics, B Vitamins, Magnesium.
- Detox Support – Glutathione requires Selenium, Glutamine & Cysteine (low levels of glutathione increase viral replication), Glycine, NAC.
- Diet Support - a personalised nutrition plan like Metabolic Balance can provide the food foundations to build from. Balancing blood sugar is a vital dietary step.
- Stay Hydrated - like with many chronic health conditions, drinking plenty of water and staying hydrated is one of the key foundations to health.
Obviously, nobody would take all of these supplements at once, but it shows how many tools we have to address viral issues, especially EBV, using nutrients and some herbs. Diet and lifestyle factors also need to be addressed. There is hope. If you are suffering from chronic fatigue or suspect chronic reactivated EBV is part of your health challenge get in touch.
I'm an EBV Certified Practitioner
Over the last year, I’ve been working with Kasia Kines of www.EBVhelp.com in her clinicians EBV Training Program. I'm now a certified EBV practitioner. Thanks to Kasia for sharing her knowledge and the huge amount of time and research she’s put into understanding EBV and developing this course.
If you'd like my help with EBV then please reach out to me via phone, email or book in a free strategy session so we can get to the bottom of your health issues.
